Part A Hospital Services D G L N
The Part A deductible is $1632 per benefit period
A benefit period starts when you are admitted to a facility
and ends 60 days after you last received inpatient care at any facilityPart A Deductible ($1632)
  • The inpatient deductible is $1632 for each benefit period
  • Days 1-60: Medicare covers 100%
  • Days 61-90: You are responsible for $408 per day
  • Days 91 until 60 day lifetime reserve is used up: Your responsibility is $826 per day
  • Beyond lifetime reserve: You are responsible for all costs incurred
Hospital Coinsurance		 Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%
Covers 365 Additional inpatient days after lifetime reserve has been used up365 days extra Hospital coverage
Skilled nursing facility coinsurance Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%
3 Pints of (unreplaced) blood Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%
Part B Services D G L N
Part B Annual Deductible ($240)



Medicare covers 80% of Part B claims, you are responsible for 20%Part B Coinsurance Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%		 You pay $20 for Dr. office visits
You pay $50 for emergency room visits$20/$50
Doctors who do not take Medicare Assignment can charge 15% above what medicare allows
Some Medicare Supplement plans cover that extra 15%Part B Excess Charges


Additional Features D G L N
Out of Pocket Limit NA NA $2560 NA
Hospice coverage Plan covers 75% of your out of pocket expenses
Your share is capped at $2560 per year75%
Foreign Travel Emergency
Monthly Rates & Brochures D G L N
Anthem
158.46
197.55
Blue Shield eff 7/1/2024
S: 147.00
Extra Rider
  • Basic gym access through sliver sneakers fitness program (silversneakers.com)
  • Personal emergency response system
  • Physician consultation by phone or video through Teladoc
  • Over the counter items through CVS (Up to $100 one time use per quarter allowance)
  • The vision benefit includes coverage for exams, frames and lenses ($100 frame allowance)
  • Hearing aid benefit includes an annual hearing aid test and coverage for Vista brand mid-level and premium-level hearing aids for a low copay
  • Acupuncture and chiropractic, up to 20 combined visits per calendar year
  • Identity theft protection
E: 164.00
169
Continental (Aetna)
215.16
154.35
Health Net 153.00
S: 161.00
Additional benefits included with Health Net Innovative plan rider
  • Routine Hearing Exam - One hearing exam every 12 months
  • Hearing Aid(s) - includes fitting evaluation. $1000 maximum for two hearing aids (one pair) or $500 for one hearing aid
  • Routine Eye Exam - One vision exam every 12 months
  • Eyewear - Up to $250 allowance for frame and lens package once every 24 months or contact lens once every 12 months
I: 156.00
128.00
Humana Achieve eff 8/1/2024
213.83
155.16
UHC eff 6/1/2024
148.20 120.88 146.32
Choosing a Medigap Policy
Continental: Add $20 application fee.
Prepared for Richard Bell
Zip code: 92832
Age: 65

Anthem rates reflect $2 automatic checking discount
Anthem Plan G rates reflect $25.00 Welcome to Medicare discount
Blue Shield rates reflect $3 automatic checking discount
Blue Shield Plan G rates reflect $25 Welcome to Medicare discount
Health Net rates reflect $30 Welcome to Medicare discount
Humana Achieve rates reflect $2 automatic checking discount
UHC rates based on Part B effective less than 10 years
UHC Plan G rates reflect $25 Welcome to Medicare discount
UHC rates reflect $2 automatic checking discount
Contact us
(714) 637-7036
[email protected]
CA Ins Lic 426442